NEET-PG 2024 Practice Questions

Q: A 14-year-old victim of sexual assault with 22 weeks gestation has been brought for Medical Termination of Pregnancy (MTP). Which of the following statements is true?

MTP can be carried out up to 24 weeks. ***MTP can be carried out up to 24 weeks*** - The **Medical Termination of Pregnancy (Amendment) Act, 2021**, allows termination of pregnancy up to **24 weeks** for certain vulnerable groups, including survivors of sexual assault and minors. - As a 14-year-old victim of sexual assault, she falls under the category which permits MTP up to 24 weeks. *One doctor is involved* - For pregnancies between 12 and 20 weeks, the opinion of **two registered medical practitioners** is required for MTP. - Beyond 20 weeks up to 24 weeks, as in this case, the opinion of **two registered medical practitioners** is also mandatory. *MTP done in 2nd trimester only when mother's life is in danger* - While danger to the mother's life is a valid reason for MTP, the **MTP Act 2021** has expanded the grounds for MTP in the second trimester (beyond 12 weeks) to include other categories like **sexual assault survivors** and **minors**, even if the mother's life is not immediately in danger. - The primary consideration here is the **vulnerability** of the pregnant person, not solely imminent danger to life. *MTP cannot be more than 20 weeks* - This statement is incorrect as per the **Medical Termination of Pregnancy (Amendment) Act, 2021**. - The Act raised the upper gestation limit from 20 to **24 weeks** for specific categories of women, including victims of sexual assault and minors, aligning with the current case.

Q: Which of the following is true regarding adipocere formation?

Preservation by saponification. ***Preservation by saponification*** - Adipocere, also known as **grave wax**, is formed through the process of **saponification**, where body fat hydrolyzes into fatty acids. - This process leads to the formation of a **waxy, grayish-white substance** that can preserve the body tissues. *High temperature needed* - Adipocere formation is actually favored by **cooler temperatures**, which slow down putrefaction and create a more conducive environment for saponification. - **High temperatures** typically accelerate decomposition, making adipocere formation less likely. *Cool and dry climate needed* - While a **cool environment** is favorable, adipocere formation primarily requires a **moist or wet environment**, such as burial in damp soil or immersion in water. - A **dry climate** would generally lead to mummification rather than adipocere formation. *Occurs within minutes to hours* - Adipocere formation is a **slow process** that usually takes **several weeks to months** (typically 3 weeks to 3 months) to become evident, and even longer to fully develop. - It does not occur within minutes or hours, which is the timeframe for early post-mortem changes like livor mortis or rigor mortis.

Q: Who orders the autopsy in the case of a Road Traffic Accident (RTA)?

B. Police. **B. Police** - In cases of Road Traffic Accidents (RTAs) and other **medico-legal deaths**, the **police** are typically responsible for ordering an autopsy. - This is because the death is suspicious and may involve criminal investigation, requiring formal authorization from law enforcement to establish the cause and manner of death. *A. Forensic expert* - A **forensic expert** performs the autopsy but does not have the authority to order it. - Their role is to conduct the examination and provide expert findings to the investigating authorities. *C. Lawyer* - A **lawyer** may be involved in the legal proceedings related to the RTA but does not have the authority to order an autopsy. - Their role is to represent clients and use the autopsy findings as evidence in court. *D. Forensic doctor* - A **forensic doctor** (or forensic pathologist) is the medical professional who conducts the autopsy. - They do not initiate the autopsy themselves but perform it upon the request of authorized parties, such as the police or a medical examiner/coroner.

Q: Mees' lines and raindrop pigmentation on the hands are seen in which type of poisoning?

Arsenic. **Arsenic** - **Mees' lines** (transverse white bands on fingernails) and **raindrop pigmentation** (hyperpigmentation with scattered hypopigmented spots) are classic dermatological manifestations of chronic arsenic poisoning. - Arsenic interferes with cellular respiration and DNA repair, leading to systemic effects including characteristic skin changes. *Thallium* - Thallium poisoning is often associated with diffuse **hair loss (alopecia)**, sensory neuropathy, and gastrointestinal symptoms. - It does not typically cause Mees' lines or raindrop pigmentation. *Cadmium* - Chronic cadmium exposure is primarily associated with **renal dysfunction** (Fanconi syndrome), **osteomalacia**, and lung disease. - It does not cause the specific nail or skin pigmentation described. *Lead* - Lead poisoning typically manifests with **gastrointestinal symptoms** (colic), neurological deficits (foot drop), and **anemia**. - While it can cause some dermatological changes, **Mees' lines** and **raindrop pigmentation** are not characteristic features.

Q: The image shows microscopic organisms. What is the most appropriate description of these organisms?

Bacteria. ***Unicellular bacteria*** - The image depicts **bacteria**, which are by definition unicellular prokaryotic microorganisms - Bacteria exhibit varied morphologies (cocci, bacilli, spirilla) which can be visualized under microscopy - This is the most appropriate description among the given options for microscopic bacterial forms *Wall contains silica and chlorophyll* - Silica cell walls are characteristic of **diatoms** (photosynthetic protists), not bacteria - Bacteria have peptidoglycan cell walls, not silica - While some bacteria contain pigments, they do not contain chlorophyll in the same form as eukaryotic organisms *Present only in bone marrow* - This statement is anatomically incorrect for bacteria - Bacteria are ubiquitous and can be found in virtually all environments - Bone marrow primarily contains hematopoietic cells, not bacteria in normal conditions *Not resistant to acid* - This is not a defining characteristic that can be determined from microscopic appearance alone - Many bacteria (e.g., *Mycobacterium tuberculosis*) are **acid-fast** and highly resistant to acid - Acid resistance varies among different bacterial species and requires specific staining (Ziehl-Neelsen) to determine

Q: A 27 -week pregnant woman with a fetus diagnosed with congenital anomalies is considering a Medical Termination of Pregnancy (MTP). Whose presence is not required for the authorization of MTP in this case?

B. Lawyer. **B. Lawyer** - The **Medical Termination of Pregnancy Act (MTP Act)** in India specifies the medical professionals required for MTP authorization. A lawyer's presence is not mandated for this medical decision. - Legal authorization involves medical personnel and, in certain cases, a **Medical Board**, but not legal professionals directly in the authorization process. *A. Obstetrician* - An **obstetrician** or gynecologist is a medical expert specializing in pregnancy and childbirth, making their presence crucial for assessing the patient's and fetal condition. - The **MTP Act** requires the opinion of at least two registered medical practitioners, especially for pregnancies beyond 20 weeks, making an obstetrician essential. *C. Pediatrician* - In cases of **fetal anomalies**, a **pediatrician** (or a neonatologist) is highly likely to be part of the Medical Board formed to evaluate the anomaly and assess the prognosis for the child. - Their expertise helps in understanding the **severity and potential outcomes** of the congenital anomaly, informing the MTP decision. *D. Sonologist* - A **sonologist** (radiologist performing ultrasound) is critical for accurately diagnosing and detailing the **congenital anomalies** through imaging. - Their report provides essential **diagnostic information** that forms the basis for the MTP decision, especially in cases where anomalies are the primary concern.

Q: A USG (ultrasound) shows two babies, one of whom appears to be one month older than the other. What is the term for this condition?

Twin-to-twin transfusion syndrome. ***Twin-to-twin transfusion syndrome*** - The observation of one baby appearing a month older than the other on ultrasound, particularly in a twin pregnancy, is highly suggestive of **twin-to-twin transfusion syndrome (TTTS)**, where there is an unequal sharing of blood between the twins. - This imbalance leads to one twin (the recipient) becoming larger and plethoric, while the other (the donor) becomes smaller and anemic, creating a noticeable size discrepancy, inaccurately noted as an "older" twin. *Superfetation* - **Superfetation** is the rare phenomenon of a second, new pregnancy occurring during an existing pregnancy, resulting in two fetuses of different gestational ages. - While it results in fetuses of different ages, it specifically refers to conception at different times, which is distinct from the described unequal growth within a single multiple pregnancy. *Superfecundation* - **Superfecundation** refers to the fertilization of two or more ova from the same ovulatory cycle by sperm from different acts of coitus or from different fathers. - It results in twins (or multiples) conceived at roughly the same time, but by different sperm, and does not explain a significant age or size discrepancy between the fetuses. *Dichorionic diamniotic twins* - **Dichorionic diamniotic (DCDA) twins** are the most common type of twins, each having their own placenta and amniotic sac. - While they are two separate pregnancies, this term primarily describes the placental and amniotic sac arrangement and does not inherently explain a significant size discrepancy or "age" difference between the twins without an underlying complication like TTTS.

Q: Identify the gene commonly involved in the condition shown in the image?

BRAF V600E. ***BRAF V600E*** - The image displays cells with **Langerhans cell morphology**, including folded nuclei and abundant pale cytoplasm, which are characteristic of **Langerhans cell histiocytosis (LCH)** [1]. - The **BRAF V600E mutation** is the most common genetic alteration found in LCH, present in about 50-60% of cases and activating the MAPK pathway [1]. *RAS* - **RAS mutations** are frequently seen in various cancers, including colorectal adenocarcinoma, pancreatic adenocarcinoma, and non-small cell lung cancer. - While RAS pathway activation can occur in LCH, a direct RAS mutation is not the most common genetic driver; rather, downstream effectors like BRAF V600E are more prominent [1]. *RET* - **RET mutations** are primarily associated with **medullary thyroid carcinoma** (in both sporadic and inherited forms like MEN 2A and MEN 2B) and can also be found in certain types of lung cancer. - They are not a characteristic genetic alteration for Langerhans cell histiocytosis. *P53* - The **TP53 gene** encodes the tumor suppressor protein p53, and mutations in this gene are among the most frequent genetic alterations across a wide spectrum of human cancers. - Although p53 plays a critical role in cell cycle regulation and apoptosis, it is not a primary or common driver mutation specifically associated with Langerhans cell histiocytosis [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of White Blood Cells, Lymph Nodes, Spleen, and Thymus, pp. 629-630.

Q: Which of the following chelating agents is indicated in iron overdose?

Desferrioxamine. ***Desferrioxamine*** - **Desferrioxamine** is a **chelate** formed by the bacterium *Streptomyces pilosus* that has a high affinity for **iron**. - It is currently the most commonly used chelating agent for **acute iron overdose** and **chronic iron overload** conditions like hemochromatosis or transfusional hemosiderosis. *BAL* - **BAL (dimercaprol)** is a chelating agent primarily used for poisoning with **arsenic**, **mercury**, and **gold**. - It works by forming stable cyclic compounds with these metals, facilitating their excretion. *Calcium Edetate* - **Calcium edetate (Calcium-EDTA)** is primarily used for **lead poisoning**. - It works by forming a stable, water-soluble complex with lead, which is then excreted by the kidneys. *DTPA* - **Diethylenetriamine pentaacetate (DTPA)** is a chelating agent primarily used for poisoning with **plutonium** and other **radioactive metals**. - It is not indicated for iron overdose. *Penicillamine* - **Penicillamine** is a chelating agent primarily used for **copper** overload (Wilson's disease) and can also be used for **lead** and **mercury** poisoning. - It is not effective for iron chelation in overdose situations.

Question 1

A 14-year-old victim of sexual assault with 22 weeks gestation has been brought for Medical Termination of Pregnancy (MTP). Which of the following statements is true?

Accepted Answer

MTP can be carried out up to 24 weeks

Answer

One doctor is involved

Answer

MTP done in 2nd trimester only when mother's life is in danger

Answer

MTP cannot be more than 20 weeks

Question 2

Which of the following is true regarding adipocere formation?

Accepted Answer

Preservation by saponification

Answer

High temperature needed

Answer

Cool and dry climate needed

Answer

Occurs within minutes to hours

Question 3

Who orders the autopsy in the case of a Road Traffic Accident (RTA)?

Accepted Answer

B. Police

Answer

A. Forensic expert

Answer

C. Lawyer

Answer

D. Forensic doctor

Question 4

Mees' lines and raindrop pigmentation on the hands are seen in which type of poisoning?

Accepted Answer

Arsenic

Answer

Thallium

Answer

Cadmium

Answer

Lead

Question 5

The image shows microscopic organisms. What is the most appropriate description of these organisms?

Accepted Answer

Bacteria

Answer

Wall contains silica and chlorophyll

Answer

Present only in bone marrow

Answer

Not resistant to acid

Question 6

A 27 -week pregnant woman with a fetus diagnosed with congenital anomalies is considering a Medical Termination of Pregnancy (MTP). Whose presence is not required for the authorization of MTP in this case?

Accepted Answer

B. Lawyer

Answer

A. Obstetrician

Answer

C. Pediatrician

Answer

D. Sonologist

Question 7

A USG (ultrasound) shows two babies, one of whom appears to be one month older than the other. What is the term for this condition?

Accepted Answer

Twin-to-twin transfusion syndrome

Answer

Superfetation

Answer

Superfecundation

Answer

Dichorionic diamniotic twins

Question 8

A 34-year-old female presented with low hemoglobin, platelet count of $25,000 / \mathrm{mm}^{3}$, raised PT and APTT. The image shows a peripheral smear. Which of the following fusion genes is affected?

Accepted Answer

PML-RARA

Answer

IGH-NSD2

Answer

INV 16

Answer

RUNX1-RUNX1T1

Question 9

Identify the gene commonly involved in the condition shown in the image?

Accepted Answer

BRAF V600E

Answer

RAS

Answer

RET

Answer

P53

Question 10

Which of the following chelating agents is indicated in iron overdose?

Accepted Answer

Desferrioxamine

Answer

BAL

Answer

Calcium Edetate

Answer

DTPA

Answer

Penicillamine

NEET-PG 2024

Forensic Medicine

Microbiology

OB/GYN

Pathology

Pharmacology